Right to Review Medical Bills and Know the Rules of Hospital Charges

  Camila Mendes

            Alysia Santo is a young woman who survived chronic leukemia (bone marrow cancer). Alysia’s cancer medication cost $8,500 a month! Unfortunately, most cancer treatment medications cost over $100,00 per year. During Alysia’s treatment plan with her doctor they discussed the cost of her care. This is an extremely important part of patient care. When a patient is hospitalized, they may not receive the opportunity to review their medical bill. Although they may not have that opportunity, it is still important for the medical staff to let the patient know about their insurance and deductible information.

            Usually the hospital sends the bill by mail, and if the patient wants to discuss it they will need to make an appointment and go to the billing department in the hospital. Trying to understand all the different charges on a bill can be exhausting and confusing. Many medical bills don’t include extensive detail about what each charge is fo; this leaves the patient confused and oblivious to what they are paying for. A patient has the right to ask about how much each procedure, medication, and treatment cost. The patient has a right to be aware of how much they are spending in the hospital and what they are paying for exactly. In order to prevent that horrid feeling after seeing an expensive medical bill, use your right as a patient to calculate how much you are paying and what your are paying for.

            Next time you are hospitalized, do not hesitate to ask for a copy of your bill and the cost of care. Knowledge about this basic information allows you, as a patient, to make more informed decisions about the care you need. Alysia was fortunate enough to have doctors who helped her receive care without going into an extreme debt. Most Americans are not that fortunate and for that reason it is important to be aware of what your are paying for and how much it will be. Ask yourself, how much is this procedure? How much is my insurance deductible? Does my insurance cover this treatment? Asking yourself these questions will help you become a wiser patient.

Right to Know Realistic Care Alternatives

Camila Mendes

            “Cindy, you have cholecystitis, we are going to do an esophagealduedunoscopy, give you cephalosporin and flagyl, and maybe a choelcystectomy.” If your head is spinning right now, imagine how the patient feels! This is a simple example of what doctors tend to do to patients. Doctors forget that patients may not understand their terminology and need a simple explanation. When this occurs patients are left confused about what their condition is and cannot plan how they would like to receive treatment. When a patient is hospitalized, they may face several hard decisions. During these times, it is imperative that the doctor explain to the patient what their options are.

            Sometimes a patient is given false hope due to a doctor’s feelings towards a patient’s condition. For example, a patient diagnosed with lung cancer that has spread to the lymph nodes, heart, and kidneys should be told that the prognosis is not good. A doctor might instead tell a patient to not lose hope. If a doctor is not realistic with the patient, it can be very difficult for them to accept the reality of their situation. It is also more difficult for a patient to understand their current health condition if they are not given realistic options. It is important that nurses also maintain this consistency with patients. When teaching them about home care or other topics that need further education the nurse must consider what is realistic for this patient. Concerns such as the patient’s economic status, drive to improve, social support, disabilities, and mental impairments all play an important role in the nurse’s teaching plan for a patient. For example, If a patient barely earns enough money to pay for their rent, it is not realistic for a nurse to create a nutrition plan with expensive foods. It is important that patients speak to their medical care team about their questions and limitations when they feel insecure about the care plan.

            Next time you are hospitalized, remember to ask yourself if the options you are given or if the teaching you are receiving is realistic to your current conditions. Medical staff sometimes forget to break down information for patients. It is your duty as a patient to let your doctor know to break the information down for you so you may plan your care effectively and realistically. “Cindy, your gall bladder is inflamed. We will use a scope called EGD to look inside your gall bladder to understand what is causing the inflammation. We will give you some antibiotics and pain medication and if the medications do not help we may have to remove your gall bladder.” Which doctor do you prefer to have? 

Patient Rights Under HIPAA

Camila Mendes

            When working at the hospital I witnessed one too many times a doctor speaking on the phone with someone about a patient’s information. The question is, is this doctor violating a patient’s HIPAA rights? The answer is yes! When a patient is hospitalized they, immediately must receive care under Health Insurance Portability Accountability Act (HIPAA). HIPAA is the law of patient care that protect patient confidentiality.

            When a doctor discusses their patient’s information in the hallway, elevator, or in the street, they are violating their patient’s HIPAA rights. When a nurse confirms that a patient is in the hospital to a person calling on the phone, the nurse is violating the patient’s HIPAA rights. When a doctor uses the patient’s name when speaking with someone outside of the patient’s care team, the doctor is violating the patient’s HIPAA rights. HIPAA laws are important because they protect patients against any type of violation of their confidential information. As a past, current or future patient, it is important for you to question medical staff when observing something that seems to violate those rights. For example, if a patient can hear a doctor speaking about another patient outside the hallway, recognizing that this is a colossal violation of patient rights and speaking up can be very helpful.

            As a patient you have a right to keep your information confidential between you and your doctor. Imagine your most personal information being shared with the public. Maybe you contracted an STD, or maybe you injured yourself while driving under the influence. For that reason you must open your eyes and ears to the information heard around you. Medical staff make mistakes all the time and sometimes the patients need to remind them of it! 

Right to Receive Respect for Advanced Derivatives

Camila Mendes

In October of 1995 an 92 year old grandmother was sent to the hospital to receive emergency care even though she had an advanced directive. She was resuscitated and kept on life support for four days until her family decided to remove her life support. The family sued the physician for ignoring the grandmother’s wishes by ignoring her DNR form. Advanced derivative is a form that states what type of care a patient would like to receive if they are unable to speak for themselves.

An advanced directive is especially common in patients with chronic illness such as malignant tumors or heart conditions. Elderly patients are also the age group who most often sign advanced directives. When a patient signs this form, they are able to individualize the care they’d like to receive if an emergency occurs such as if they begin to code (have no pulse or respiration). When a code occurs, a patient could receive no care from medical staff, this is called a “Do Not Resuscitate” (DNR) order. Medical errors with DNRs have occurred time and time again because the medical staff did not properly check the patient’s paperwork. In this occasion, the medical staff begin CPR on the patient and possibly resuscitate them, not following their wishes. The grandmother, whose wishes were not respected, is just one among thousands of different cases of medical negligence. The best way to avoid this problem is by reminding your doctor and your family members of your DNR form.

Medical staff forget time and time again to chart DNR orders. Sometimes, medical staff forget to check the chart themselves. If you have a DNR form, remember to remind your doctor and nurse of it. Also, considering you may be unable to speak for yourself at some point, remind your family of your DNR.

Right to Informed Consent

Camila Mendes       

                      

       

According to Michael J. Schoppmann, a health care attorney, failure to obtain informed consent from their patients is one of the biggest reasons doctors get sued in U.S.A. Informed consent is an extremely important part of a patient’s care. With consent, the patient remains in control of the care they receive. Without consent, a doctor may not perform the specific procedure on a patient and failure to follow this law will not only often lead to a lawsuit, but a betrayal of their patient’s trust.

When the patient is admitted to the hospital, they have may need special care. The patient may receive surgery, such as a mastectomy (removal of the breast tissue). The patient may receive a cardioversion (fast heart rhythm is slowed through electrical impulses to the heart) to help stabilize their heart rhythm. The patient may also receive an invasive procedure such as a biopsy (removal of tissue to be observed). When these different procedures a performed, a patient needs to sign an informed consent form. This form states that the patient knows what the procedure is, why they will receive it, and the complications. If a patient does not sign the consent form, the hospital staff cannot begin the procedure. For this reason, this is one extremely important patient right. The patient should always have control over the care they receive.

The next time you or a family member is hospitalized, ask yourself if you or your family member signed an informed consent. If you are unsure about the procedure or treatment plan, do not hesitate to talk to your doctor. In order to make an informed decision about the best option for yourself or someone else, you first need to know what your options are.